If you’re scientifically minded like I am, you might be inclined to dismiss these stories as fantasy, or the result of a person’s gullibility rather than acknowledging that a genuine healing event took place. But before you do, I ask that you consider remarkable research being done around the world suggesting that the effects of our expectations and beliefs may account for good-to-excellent health improvement for almost 70 percent of us.
In hundreds of studies produced in leading academic institutions, the seemingly innocuous “placebo effect” has been shown to have a profound influence on our health. Here are some of my favourites:
- For people being treated for severe nausea and vomiting, placebo tablets can be just as effective as taking drugs.
- 30 percent of people with a moderate to severe migraine can recover with a placebo, and the effect is enhanced if the placebo is administered via an injection rather than in a tablet.
- Taking a placebo four times a day can make an ulcer heal more quickly than taking a placebo twice a day.
- Patients who adhere to taking their prescribed fake pills do significantly better than those who take only some of them.
- The more expensive the placebo, the better it is at reducing pain.
While you may be reading all this thinking that it can be easily explained by the fact that people’s subjective experience of pain means they merely think that they’re getting better, it turns out that far from being a purely subjective occurrence that lies “all in the mind,” researchers are no longer asking if the placebo effect works, but rather, how the placebo effect works.
I recently interviewed Fabrizio Benedetti, a leading neurophysiologist from the University of Turin in Italy who spends his working hours trying to determined exactly when, where, and how your beliefs and expectations can induce a physiological response in your body. (Hear the podcasted interview with him at the end of this post.)
Benedetti’s research shows that there exists not one single placebo effect, but rather, many placebo effects which work in different ways. For example, he’s shown that placebos can work in a way similar to morphine by using the endogenous opioid system, the body’s innate pain-relieving system. Another study of Parkinson’s disease patients demonstrated placebos could induce a 200 percent increase in dopamine, which is the chemical in your brain that makes you anticipate pleasure and reward.
As I wrote in my post How My Grandma Accidentally Used Placebo To Fix Her Chronic Pain, another way placebos can work is through a process called “classical conditioning”, which is essentially your body’s way of learning to respond to a stimulus such as a drug. After a while, when researchers switch out the real stimulus for a fake one, your body can respond as if the real one had been administered. For example, a 2007 study opened up a whole can of worms for anti-doping authorities in sports when it demonstrated that athletes given a performance-enhancing drug during pre-competition training could be given a placebo on the day of competition and still experience an increase in pain endurance and physical performance.
Classical conditioning has fascinating possibilities when it comes to medicine for sick people. Benedetti recently demonstrated that he could reduce drugs given to people suffering from Parkinson’s disease by first treating them with the anti-Parkinson’s medication apomorphine and then, on a subsequent administration, giving them a fake. When he gave them them the placebo, their body responded as if they’d been given the real drug. “If you give an anti-Parkinson agent on Monday, on Tuesday, on Wednesday, on Thursday, and on Friday, and then on Saturday you replace the real drug with a fake drug, virtually all patients will respond,” Benedetti explained.
All this is not to say that you can be given any fake pill to heal any ailment. Benedetti is careful to highlight that drinking a glass of water or taking a sugar pill to cure a bacterial infection is not likely to work, no matter how much you believe in its power. “There are some conditions in which a placebo response is not present at all. It’s completely absent. There are other conditions in which the placebo response is very important, like depression, pain, movement disorders, and the general neuropsychiatric disorders,” he said.
Compelling as the new science of placebo is, it should not be thought of in any way as a replacement for the active treatments of modern medicine. But the main point here is that although there is still much to discover, there are many ways that your beliefs and expectations could influence your health. If you respond to a placebo it may be because you’ve been conditioned to respond (like the elite athletes and Parkinson’s patients), it may be that pain-reliving chemicals are triggered in your brain, or, as I wrote about in my blog post Does Alternative Therapy Work?, it may be that your doctor has reassured you enough to make you feel less anxious, which improves your mood and makes you feel better.